Sexual Function and Neuropathy in Pre-Diabetes and Type 2 Diabetes
A common health problem among both men and women, sexual dysfunction increases with advancing age and markedly reduces quality of life (QOL). Our team’s findings from people with type 1 diabetes (T1DM) in the Epidemiology of Diabetes, Interventions and Complications (EDIC) study–the observational extension of the Diabetes Control and Complications Trial (DCCT)–showed that 45% of men reported erectile dysfunction (ED) and 42% of women reported female sexual dysfunction (FSD). Poor glycemic control and cardiac autonomic neuropathy significantly increased risk of ED and FSD in this cohort. Although our findings in EDIC have begun to shed light on the role of prevalent T1DM on sexual dysfunction, data defining the burden, and risk reduction strategies among people who are at risk for type 2 diabetes (T2DM) are limited. The Diabetes Prevention Program (DPP), a randomized controlled trial of overweight and obese men and women at high risk for T2DM, and its observational follow up, the Diabetes Prevention Program Observational Study (DPPOS) now in its 18th year, demonstrated that intense lifestyle intervention and metformin both delayed the onset and progression of T2DM and its complications. At year 15, DPPOS participants completed the International Index of Erectile Function (IIEF) and Female Sexual Function Index (FSFI) yielding validated measures of sexual dysfunction for both genders. We hypothesize that sexual dysfunction in men and women with prediabetes and T2DM is highly prevalent and less favorable trajectories of glycemia and neuropathy predict those at highest risk. Accordingly, we propose to utilize existing data from DPPOS to test these hypotheses. By fully leveraging data in an existing, NIH-funded study, we avoid costs associated with primary data collection and facilitate generation of new knowledge that (1) builds on a growing body of research on the urological complications of DM and (2) has been defined as a high priority to the NIH and other stakeholders.